Perceived levels of pain, disability, emotional distress, and somatic preoccupation were rated by internists after reading a vignette.

Ratings of pain and disability were lower for patients without supporting medical evidence ; ratings of distress, somatic preoccupation, and disability were greater for patients who exhibited negative rather than positive affect ; internist ratings of pain were lower than patient ratings among patients reporting high levels of pain, while ratings were inflated for patients with low levels of pain.

The results suggest that characteristics of both the patient and the situation may influence medical judgments.